measurements carefully. The doll measurements may not be 100% exact. I do NOT guarantee
exact measurements (as exact dolls are rare), but I do try to get as close as possible. The toes
are sculpted and the arms & legs have joints.The doll prices include shipping in continental US,
soft fleece hat, diaper, doll tag &‘birth certificate’ (not a legal document). Orders may take up to 8 weeks per doll (’normal’ doll) or up to 12 weeks per doll
(’specialty doll’ with pattern adjustments) to arrive, (international orders may take 6-10 extra days to arrive & you will need to pay duties & taxes in your country). The up to 8 weeks per doll (for a
normal doll) or up to 12 weeks per doll (specialty doll) will begin when I recieve payment (payable
to REMEMBER ME PREEMIE / personal checks will add 2 weeks to your order, as I can not begin your doll until
the check clears my bank) & when I start your doll (I make dolls in the order I recieve them, except
expedited dolls - I make them at the same time as the order I was previously working on).
International orders must contact us before ordering. I prefer that payment be made by money order or cashier's check, (payable to Remember Me Preemie).
Payment made by Personal check will add 2 weeks to your order as it takes up to 2 weeks
for personal checks to clear my bank. Personal checks are only accepted from the
continental US, (contact us for other payment arrangements). These dolls are keepsakes and are NOT toys as they contain small parts. All dolls contain metal
parts (in the joints & metal bb's). Please spot clean only (do not get the doll wet) as metal
parts may rust. The materials inside of these dolls may shift durring shipping, (If the shape of the
doll's head or chest looks odd you can gently reshape it with your hands). Like a real preemie the
head is wobbly & needs to be supported, (the head is about 1/3 of the weight).
Please carefully choose the type of weight you want your doll to be & please check your measurements
carefully. Not all dolls ordered as 'Feels Right' weight will feel the size they look, as some dolls the 2/3 of
the birth weight does not match with the baby's birth measurements & the doll may feel lighter than it looks.
Continental US dolls returned to change the weight (or make any other changes to your doll)
have a $20 charge to make the changes and re-ship it. International dolls returned to change the
weight (or make any other changes to your doll) will need to
contact us for additional shipping fees.
I reserve the right to put photos of your doll(s) on my website (with the gestational age & length).
None of your baby's personal information will be used on my website without your permission.
By signing this I acknowledge that I have read the Purchaser Agreement (above) and that I understand it.
Signature:_____________________________________________ Date:________________
Please Print your Name_______________________________________________________
Address______________________________ City___________________ State______
Zip Code__________
Phone (_____) ____________________ E-mail____________________________________
How did you hear about Remember Me Preemie?___________________________________
Shipping to a different address? Check here _____ & write the other address on the back.
Is this child: ____ living or ____ deceased?
(I don't want to offend anyone, especially if their child is no longer living)
For ‘specialty dolls’ please contact us with photos & a description before ordering!
Gestation_______ weeks ______ days
Birth measurements: ( ) unknown
Head_______ cm; Chest________ cm; Length_______ in; Weight______ lbs. ______ oz.;
Foot length______ cm
If you have any other measurments write them in the extra space (hand (wrist to longest finger), wrist,
arm length, bicep, abdomen, thigh or ankle).
Skin color: ( ) Peach ( ) Golden ( ) Tan ( ) Light Brown ( ) Dark Brown
Arms: ( ) Bent ( ) Straight
Legs: ( ) Bent ( ) Straight
Hat color: ( ) Pink ( ) Blue ( ) Neutral
Hat type: ( ) Bow top ( ) Round top (see 'doll photos' for the different hat types)
Face: ( ) Painted ( ) Sculpted ( ) No Face
Doll Weight: ( ) 'Feels Right' weight ( ) 'Real' weight
Doll Options & Accessories:
Anatomically Correct Doll: ( ) Boy ($6) ( ) Girl ($3)
Pipe cleaner fingers ($5 - only for dolls 10" or longer): ( )
Pipe cleaner mitts ($5 - only for dolls 10" or smaller): ( )
Flannel blanket with blanket binding ($9 ): ( ) Pink ( ) Blue ( ) Neutral
Tiny flannel doll blanket with ties ($5 - for dolls 10" or smaller): ( ) Pink ( ) Blue ( ) Neutral
Doll hair/wig ($10): ( ) Camel ( ) Rust ( ) Brown ( ) Black
Congental hip dysplasia (no fee): ( ) Right leg ( ) Left leg ( ) Both legs
Gown ($9): ( ) Girl print ( ) Boy print ( ) Neutral print
Sleeper ($9): ( ) Girl print ( ) Boy print ( ) Neutral print
Shirt ($9): ( ) Girl print ( ) Boy print ( ) Neutral print
Soft Personalized ID Bracelet ($5): ( ) Blue only
Reuseable Vinyl Personalized ID Bracelet ($5): ( ) Pink ( ) Blue
Personalization for ID bracelet (you can use the template below or design your own by writting it to the side - up to 5 lines.)
(I will word the bracelet the same way you print it on the lines. If you prefer grams &/or cm write it to the side):
Name:___________________________________
Date of birth:___________________________ Time of birth:_________ am or pm
Weight: _______ lbs. _______ oz. Length: ________ in.
Gestation:_______ weeks _____ days
________________________________
Custom Doll Tag ($5): ( ) White
(I will word the tag the same way you print it on the lines)
Custom Doll Tag (40 characters per line): _________________________
(characters: spaces, commas, _________________________
letters, numbers, ect.) _________________________
_________________________
_________________________
_________________________
Flannel colors & prints may vary.
Order Summary
Prices are subject to change
| Quantity | Product Discription | Price | Total |
| | Dolls under 12 oz. (less than 20 weeks) | contact us | |
| | 'Feels Right' weight Dolls 12 oz. - 1 lb. 8 oz. (about 20 weeks to 24 weeks) | $85 | |
| | 'Feels Right' weight Dolls 1 lb. 9 oz. - 2 lbs. (about 24 weeks to 26 weeks) | $90 | |
| | 'Feels Right' weight Dolls 2 lbs. 1 oz. - 4 lbs. (about 26 weeks to 32 weeks) | $95 | |
| | 'Feels Right' weight Dolls 4 lbs. 1 oz. - 5 lbs. 8 oz. (about 32 wks to 36 wks) | $125 | |
| | 'Feels Right' weight Dolls 5 lbs. 9oz. + (about 36 weeks +) | $135 | |
| | 'Real' weight Dolls 12 oz. - 1 lb. 8 oz. (about 20 weeks to 24 weeks) | $95 | |
| | 'Real' weight Dolls 1 lb. 9 oz. - 2 lbs. (about 24 weeks to 26 weeks) | $100 | |
| | 'Real' weight Dolls 2 lbs. 1 oz. - 4 lbs. (about 26 weeks to 32 weeks) | $105 | |
| | 'Real' weight Dolls 4 lbs. 1 oz. - 5 lbs. 8 oz. (about 32 weeks to 36 weeks) | $135 | |
| | 'Real' weight Dolls 5 lbs. 9oz. + (about 36 weeks +) | $155 | |
| | 'Specialty Doll' | contact us | |
| | Anatomically Correct Girl | $3 | |
| | Anatomically Correct Boy | $6 | |
| | Pipe cleaner fingers (only for dolls 10" or longer) | $5 | |
| | Pipe cleaner mitts (only for dolls 10" or smaller) | $5 | |
| | Custom Doll Tag | $5 | |
| | Reusable Vinyl Personalized ID Bracelet | $5 | |
| | Gown, Sleeper &/or Shirt | $9 | |
| | Soft Personalized ID Bracelet (with extra stickers) | $5 | |
| | Flannel Blanket with blanket binding | $9 | |
| | Tiny flannel doll blanket with ties (for dolls 10" or smaller) | $5 | |
| | Extra diaper (all dolls come with one diaper) | $1 | |
| | Doll Hair/Wig | $10 | |
| | Sub Total | |
| | | | |
| | Sales Tax (Kansas Residents Only) | contact us | |
| | Optional Delivery Insurance | $5 | |
| | Expaditing/Rush Order | contact us | |
| | Ground Shipping Charge in continental United States | FREE | |
| | Shipping for orders outside of continental United States | contact us | |
| | | TOTAL | |